A nursing student is preparing to give a pregnant woman heparin ...

[clippers!]

A nursing student is preparing to give a pregnant woman heparin for a deep vein thrombosis (DVT). The student questions the dose, as it is higher than what the student has given to other patients. What response by the perinatal nurse is most appropriate?
 
  A.
  Have the student hold the dose and double-check the order with the provider.
  B.
  Inform the student that physiological changes in pregnancy require higher doses.
  C.
  Remind the student that large doses are needed to dissolve the existing clot.
  D.
  Tells the student to administer the dose and check results of the next laboratory draw.

Question 2

The perinatal nurse teaches the postpartum woman about warning signs regarding the development of postpartum infection. The nurse teaches that fever and which of the following symptoms need to be assessed by a health-care provider?
 
  A.
  Breast engorgement
  B.
  Diarrhea
  C.
  Emotional lability
  D.
  Uterine tenderness

[Bigfoot1984]

Answer to Question 1

ANS: B
The pregnant patient has a greater plasma volume and an increased renal clearance (due to increased blood flow to the kidneys). The combination of normally occurring heparin-binding proteins along with the breakdown of heparin often results in the need for higher doses of heparin during pregnancy.

Answer to Question 2

ANS: D
During the immediate postpartum period, the most common site of infection is the uterine endometrium. This infection presents with a temperature elevation over 101 F (38.4 C), often within the first 24 to 48 hours after childbirth, followed by uterine tenderness and foul-smelling lochia.